Effect of Hypericum perforatum on Early Wound Healing after Tooth Extraction: A Randomized Controlled Clinical Trial
Hypericum Perforatum and early wound healing
Abstract
Objectives: Hypericum perforatum (H. perforatum) has natural anti-inflammatory properties when used as a dressing on ulcers and burn wounds. The aim of this study was to investigate the effect of topical application of hydroethanolic gel of H. perforatum on soft tissue healing in tooth extraction sockets.
Materials and Methods: This split-mouth randomized controlled clinical trial was performed on 30 patients aged 18-30 years who required simultaneous extraction of maxillary premolars bilaterally for orthodontic reasons. After tooth extraction, 2mL of 3% H. perforatum gel was injected into the extraction socket in the intervention side. Pain was measured based on a Numeric Rating Scale (NRS). Socket healing was assessed using the standardized Landry, Turnbull, and Howley index. Repeated measures ANOVA and generalized estimating equations (GEE) were employed to compare different indices between the two groups (alpha=0.05).
Results: The mean age of the participants was 23.53 years. Of all, 25 were females and 5 were males. The intervention side had a significantly lower pain than the control side (P<0.05). The wound size decreased at 3 and 7 days, and it was smaller in the intervention side than the control side (P<0.05). The healing index score was significantly higher in the intervention side than the control side (P<0.001).
Conclusion: The results showed that 3% H. perforatum hydroethanolic gel was effective for promoting soft tissue healing in tooth extraction sockets, decreasing pain, and improving the wound healing index.
2. Saghiri MA, Asatourian A, Sheibani N. Angiogenesis and the prevention of alveolar osteitis: a review study. J Korean Assoc Oral Maxillofac Surg. 2018 Jun;44(3):93-102.
3. Eid RAA. Efficacy of Commiphora myrrh mouthwash on early wound healing after tooth extraction: A randomized controlled trial. Saudi Dent J. 2021 Jan;33(1):44-54.
4. Abu-Mostafa N, Al-Daghamin S, Al-Anazi A, Al-Jumaah N, Alnesafi A. The influence of intra-alveolar application of honey versus Chlorhexidine rinse on the incidence of Alveolar Osteitis following molar teeth extraction. A randomized clinical parallel trial. J Clin Exp Dent. 2019 Oct 1;11(10):e871-e876.
5. Gupta A, Rattan V, Rai S. Efficacy of Chitosan in promoting wound healing in extraction socket: A prospective study. J Oral Biol Craniofac Res. 2019 Jan-Mar;9(1):91-95.
6. Rathi VC, Jain A, Kumar S, Sonone R, Yadav S, Shaikh SM. A comparative study to evaluate the efficacy of Azadirachta indica (neem) and Curcuma longa (turmeric) in extraction socket. Natl J Maxillofac Surg. 2019 Jul-Dec;10(2):191-194.
7. Galeotti N. Hypericum perforatum (St John's wort) beyond depression: A therapeutic perspective for pain conditions. J Ethnopharmacol. 2017 Mar 22;200:136-146.
8. Saddiqe Z, Naeem I, Maimoona A. A review of the antibacterial activity of Hypericum perforatum L. J Ethnopharmacol. 2010 Oct 5;131(3):511-21.
9. Lavagna SM, Secci D, Chimenti P, Bonsignore L, Ottaviani A, Bizzarri B. Efficacy of Hypericum and Calendula oils in the epithelial reconstruction of surgical wounds in childbirth with caesarean section. Farmaco. 2001 May-Jul;56(5-7):451-3.
10. Süntar IP, Akkol EK, Yilmazer D, Baykal T, Kirmizibekmez H, Alper M, et al. Investigations on the in vivo wound healing potential of Hypericum perforatum L. J Ethnopharmacol. 2010 Feb 3;127(2):468-77.
11. Wölfle U, Seelinger G, Schempp CM. Topical application of St. John's wort (Hypericum perforatum). Planta Med. 2014 Feb;80(2-3):109-20.
12. adollah-Damavandi S, Chavoshi-Nejad M, Jangholi E, Nekouyian N, Hosseini S, Seifaee A, et al. Topical Hypericum perforatum Improves Tissue Regeneration in Full-Thickness Excisional Wounds in Diabetic Rat Model. Evid Based Complement Alternat Med. 2015;2015:245328.
13. Yücel A, Kan Y, Yesilada E, Akın O. Effect of St.John's wort (Hypericum perforatum) oily extract for the care and treatment of pressure sores; a case report. J Ethnopharmacol. 2017 Jan 20;196:236-241.
14. Chen H, Muhammad I, Zhang Y, Ren Y, Zhang R, Huang X, et al. Antiviral Activity Against Infectious Bronchitis Virus and Bioactive Components of Hypericum perforatum L. Front Pharmacol. 2019 Oct 29;10:1272.
15. Rizzo P, Altschmied L, Ravindran BM, Rutten T, D'Auria JC. The Biochemical and Genetic Basis for the Biosynthesis of Bioactive Compounds in Hypericum Perforatum L., One of the Largest Medicinal Crops in Europe. Genes (Basel). 2020 Oct 16;11(10):1210.
16. Maisenbacher P, Kovar KA. Analysis and stability of Hyperici oleum. Planta Med. 1992 Aug;58(4):351-4.
17. Galeotti N, Vivoli E, Bilia AR, Vincieri FF, Ghelardini C. St. John's Wort reduces neuropathic pain through a hypericin-mediated inhibition of the protein kinase Cgamma and epsilon activity. Biochem Pharmacol. 2010 May 1;79(9):1327-36.
18. Çanakçı FG, Etöz O. The Effect of Hypericum Perforatum on Alveolar Bone Healing After Tooth Extraction. Meandros Medical And Dental Journal. 2022;23(3):269-74.
19. Motallebnejad M, Moghadamnia A, Talei M. The efficacy of Hypericum perforatum extract on recurrent aphthous ulcers. J Med Sci. 2008;8(1):39-43.
20. Sardella A, Lodi G, Demarosi F, Tarozzi M, Canegallo L, Carrassi A. Hypericum perforatum extract in burning mouth syndrome: a randomized placebo-controlled study. J Oral Pathol Med. 2008 Aug;37(7):395-401.
21. Mokhtari S, Sanati I, Abdolahy S, Hosseini Z. Evaluation of the effect of honey on the healing of tooth extraction wounds in 4- to 9-year-old children. Niger J Clin Pract. 2019 Oct;22(10):1328-1334.
22. Nimma VL, Talla HV, Bairi JK, Gopaldas M, Bathula H, Vangdoth S. Holistic Healing Through Herbs: Effectiveness of Aloe Vera on Post Extraction Socket Healing. J Clin Diagn Res. 2017 Mar;11(3):ZC83-ZC86.
23. Menegazzi M, Masiello P, Novelli M. Anti-Tumor Activity of Hypericum perforatum L. and Hyperforin through Modulation of Inflammatory Signaling, ROS Generation and Proton Dynamics. Antioxidants (Basel). 2020 Dec 28;10(1):18.
24. Altan A, Aras MH, Damlar İ, Gökçe H, Özcan O, Alpaslan C. The effect of Hypericum Perforatum on wound healing of oral mucosa in diabetic rats. Eur Oral Res. 2018 Sep;52(3):143-149.
25. Albert D, Zündorf I, Dingermann T, Müller WE, Steinhilber D, Werz O. Hyperforin is a dual inhibitor of cyclooxygenase-1 and 5-lipoxygenase. Biochem Pharmacol. 2002 Dec 15;64(12):1767-75.
26. Samadi S, Khadivzadeh T, Emami A, Moosavi NS, Tafaghodi M, Behnam HR. The effect of Hypericum perforatum on the wound healing and scar of cesarean. J Altern Complement Med. 2010 Jan;16(1):113-7.
27. Oztürk N, Korkmaz S, Oztürk Y. Wound-healing activity of St. John's Wort (Hypericum perforatum L.) on chicken embryonic fibroblasts. J Ethnopharmacol. 2007 Apr 20;111(1):33-9.
| Issue | Vol 23 (Continuously Published Article-Based) | |
| Section | Original Article | |
| Keywords | ||
| Hypericum perforatum Wound Healing Tooth Extraction | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
